Objective: Simulation technologies are used to assess and teach competencies through the provision of reproducible stimuli. They have exceptional utility in assessing responses to clinical stimuli that occur sporadically or infrequently. In this article, the authors describe the utility of emerging simulation technologies, and discuss critical…

What lies beneath the formal or overt curriculum may impair students' professional growth and development, including their ability to foster genuine relationships with patients and others, and may contribute to the inadvertent, often negative attitudes, beliefs, and behaviors expressed by medical students and witnessed by educators within and…

A diagnostic evaluation for a person with suspected Alzheimer's disease is usually initiated by family members whose concerns go beyond strictly medical issues. To determine precisely what questions families want answered, a 15-point questionnaire was developed at a multi-disciplinary geriatric assessment clinic. Caregivers were asked to rate each…

A major demonstration and evaluation project was undertaken to study the consequences of using incentive payments to change admission, discharge, and outcome patterns for Medicaid patients in nursing homes. Thirty-six proprietary, Medicaid-certified, skilled nursing homes in San Diego County with a combined Medicaid inpatient census of…

With improvements in medical technology and an increase in life expectancy, there also has been a substantial increase in the number of individuals with chronic diseases. The chronically ill elderly, who absorb an ever-growing proportion of our public and private resources, are of particular concern. This study analyzes findings from a major…

Use of a nursing assessment/patient history tool developed by project faculty at the school of nursing, University of California, San Francisco and used in a primary care clinic assisted nursing students in collecting patient information, making home visits, functioning as team members, recording data, and in defining their nursing role. (EA)

This literature review and bibliography resulted from a study to design a method for determining the impact of the computerized problem-oriented medical record (POMR) on the nursing components of patient care. The POMR is a system for the documentation of patient care consisting of four related components: a data base, problem list, initial plans…

It was shown that terminal patients of physicians with high death anxiety survive longer during their final hospital stay than terminal patients of physicians with low death anxiety. Physicians high in death anxiety seem to be less willing to accept patients' terminality and use heroic measures to keep them alive. (Author)

This paper presents brief case summaries of four patient suicides; explores the reactions of each therapist; presents conclusions regarding the mourning process following patients' suicides; and puts forth implications and suggestions for training programs. (Author)

Conducted interviews with family caregivers, patients, and staff of hospital before and after implementation of Diagnostic Related Groupings (DRGs). After DRGs, family and patients were more likely to express concern about problems in hospital admissions, discharge, and quality of care. Families increasingly served as mediators, supervisors, and…

Two main goals in the care of the terminally ill are to optimize the quality of their remaining life and to alleviate the distress of their survivors. Pain control research has contributed significantly to meeting those goals, but continued progress is needed in both basic studies and expanded applications of new techniques. (Author/NB)

Assigned chronic low back pain patients to operant behavioral (OB) treatment, cognitive-behavioral (CB) treatment, or waiting-list (WL) condition. Both treatments resulted in decreased physical and psychosocial disability. OB patients' greater improvement leveled off at followup; CB patients continued to improve over the 12 months following…

Advocacy has moved from a posture of interceding for clients to acting as guardian of the client's rights to autonomy and free choice. In spite of counterforces, such as perceived loyalty to an employer, nurses have been able to serve as advocates to clients as individuals and as groups. (JOW)

Reviews properties and pharmacological effects of medications for pain, including peripherally acting analgesics, centrally acting narcotics, and adjuvant analgesics including antidepressants. Discusses the role of the endogenous opioid system in pain and depression. Explores clinical management issues in both inpatient and outpatient settings,…

Assigned 43 chronic pain patients to couples group treatment, patient-only group treatment, or waiting-list control. The 16-hour cognitive-behavioral program produced reduction in pain, spouse-observed pain behavior, physical and psychosocial dysfunction, marital satisfaction, and use of health care resources. Spouse involvement did not facilitate…